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Pyomyositis
  1. Anand K Annamalai1,2,
  2. C Gopalakrishnan3,
  3. M Jesuraj4,
  4. G Sureshkumar4,
  5. M Chelian5,
  6. K G Srinivasan6
  1. 1Department of Endocrinology and Diabetes, Nithilaa Multispeciality Hospital, Madurai, Tamil Nadu, India
  2. 2Department of Endocrinology, Vadamalayan Multispeciality Hospitals, Madurai, Tamil Nadu, India
  3. 3Department of General Surgery and Urology, Nithilaa Multispeciality Hospital, Madurai, Tamil Nadu, India
  4. 4Department of Medicine, Nithilaa Hospital, Madurai, Tamil Nadu, India
  5. 5Department of Anaesthesiology, Nithilaa Hospital, Madurai, Tamil Nadu, India
  6. 6Department of Radiology, KGS Scan Centre, Madurai, Tamil Nadu, India
  1. Correspondence to Dr Anand K Annamalai, Department of Endocrinology and Diabetes, Nithilaa Hospital, Madurai, Tamil Nadu, India; ak_md2000{at}yahoo.com

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Pyomyositis is a primary bacterial infection of skeletal muscles presenting with minimal clinical symptoms during the early stages and affects immunocompetent and immunocompromised individuals.1 MRI is a sensitive and specific imaging modality for early detection.1 Here we report a young man with a recent history of type 2 diabetes and recovery from hepatitis E presenting with right thigh pain and minimal erythema diagnosed with right thigh pyomyositis with the assistance of an early MRI.

A 39-year-old man presented with a 5 day history of non-specific pain over the right thigh and a low grade fever. He was diagnosed with type 2 diabetes 3 months ago and had recovered from viral hepatitis E infection 4 weeks ago. Clinical examination revealed mild tenderness over the right thigh with normal overlying skin. Investigations revealed leucocytosis 18×109/l (reference range (RR) 4–12) with a normal creatine kinase (CK) value of 31·7 U/l (RR 24–195), HbA1c of 7·2% and a normal HIV antibody test.

The patient was advised admission to hospital and …

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